Zhu Hongda, Xie Qing, Zhou Yu, Chen Hong, Mao Ying, Zhong Ping, Zheng Kang, Wang Yongfei, Wang Yin, Xie Liqian, Zheng Mingzhe, Tang Hailiang, Wang Daijun, Chen Xiancheng, Zhou Liangfu, Gong Ye
Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, 12# Wu Lu Mu Qi Road, Shanghai 200040, China.
Department of Neuropathology, Huashan Hospital, Fudan University, Shanghai, China.
J Clin Neurosci. 2015 Apr;22(4):690-5. doi: 10.1016/j.jocn.2014.10.023. Epub 2015 Mar 3.
Meningioma is the most frequently reported primary brain and central nervous system tumor. However, malignant meningioma is rare with the anaplastic subtype the most common. This subtype of meningioma is fatal with a high recurrence rate and poor survival. A retrospective review of anaplastic meningioma patients treated in one of the largest neurosurgical centers in China between 2003 and 2008 was conducted. From 70 identified patients, seven were lost to follow-up, but the remaining 63 patients were studied for prognostic factors. The mean follow-up time was 84.9±standard deviation (SD) of 19.7months. Tumor recurred in 35 out of 63 (55.6%) patients. Thirty-three (52.4%) patients had died by the most recent follow-up, and the median overall survival (OS) was 70.0±9.7months. The 3year and 5year survival rates were 68.3% and 54.7%, respectively. The median progression-free survival (PFS) was 52.0±9.9months, whereas the 3year and 5year PFS rates were 60.2% and 43.9%, respectively. We found that preoperative KPS, extent of tumor resection, radiotherapy, tumor location and previous history of meningioma were factors related to PFS. In the non-recurrent group, the preoperative Karnofsky Performance Scale (KPS), extent of tumor resection and radiotherapy correlated with PFS. However, multivariate analysis identified radiotherapy as the only independent factor affecting PFS (p=0.007). Additionally, MIB-1 proliferation index failed to identify a cut-off point to predict the prognosis for anaplastic meningioma. This study provides an overview of the epidemiology and treatment of anaplastic meningioma in China using a large population.
脑膜瘤是最常报道的原发性脑和中枢神经系统肿瘤。然而，恶性脑膜瘤很少见，间变性亚型最为常见。这种亚型的脑膜瘤具有致命性，复发率高且生存率低。对2003年至2008年期间在中国最大的神经外科中心之一接受治疗的间变性脑膜瘤患者进行了回顾性研究。在70例确诊患者中，7例失访，但其余63例患者被研究预后因素。平均随访时间为84.9±标准差（SD）19.7个月。63例患者中有35例（55.6%）肿瘤复发。到最近一次随访时，33例（52.4%）患者死亡，中位总生存期（OS）为70.0±9.7个月。3年和5年生存率分别为68.3%和54.7%。中位无进展生存期（PFS）为52.0±9.9个月，而3年和5年PFS率分别为60.2%和43.9%。我们发现术前KPS、肿瘤切除范围、放疗、肿瘤位置和既往脑膜瘤病史是与PFS相关的因素。在未复发组中，术前卡诺夫斯基功能状态评分（KPS）、肿瘤切除范围和放疗与PFS相关。然而，多因素分析确定放疗是影响PFS的唯一独立因素（p=0.007）。此外，MIB-1增殖指数未能确定一个切点来预测间变性脑膜瘤的预后。本研究使用大量人群概述了中国间变性脑膜瘤的流行病学和治疗情况。
